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    IOWA PUBLIC CHARTER SCHOOL

    Application for Public Charter School Status

    Name of Proposed School: Walnut Charter School

    Applicant: Cynthia Jensen, Rhonda Brockmann, & Sarah Kock

    Address: 415 Antique City Drive

    Walnut, Iowa 51577

    Telephone Number: Day (712) 784-3615 Fax (712) 784-2177

    Brief description of proposed school (for media distribution):

    The Walnut Charter School shall be a conversion of the traditional public Walnut CommunitySchool's entire K-12 system. Walnut Charter School will be an educational community ofcharacter and service. The focus of the charter will be character education and service, withcomprehensive character education integrated into all levels of the curriculum, and theimplementation of a Community Action Project program of student-generated service-learningprojects for all students. Research shows that these additions to the educational program willresult in positive student achievement gains.

    County: Pottawattamie County

    Local School District: Walnut Community School District

    Intermediate School District: NA

    Name of Educational Service Provider: NA

    Number of Students in the district by elementary, middle and high school as appropriate to thecharter school:

    Elementary: 67 Junior High: 24 High School: 26

    Is the proposal a new school within an existing school? No

    Is the proposal converting an existing school to charter school status? Yes

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    Faculty, Parents, and School Board were informed of:

    Why is the charter school being formed?

    The charter school is being formed to address several communal and educational needs; amongthem is the slow decline of our school district caused by low enrollment numbers and lack offunding, the moral and ethical decline of our youth population, and the parents' feelings ofdisenfranchisement. The opportunity to be innovative in the way we present our curriculum willattract students to our charter school and provide parents with an option that is not available tothem at this time. Charter Schools have a wide variety of funding available to them from publicand private sources to help address the financial constraints with which all schools in the countryhave been struggling. By becoming a charter school, we will have a focus so that we canemphasize the character and service-learning portion of our curriculum rigorously. Thedeterioration of moral character and ethics among the youth in our country is a well-documentedtrend, and as evidenced by several studies, this trend has not missed rural Iowa. Charactereducators contend that we are experiencing a national "crisis of character" that necessitates theinclusion of formalized curricula in character in public schools (Likona, 1996; JosephsonInstitute for Ethics, 2002). At a community meeting, parents and community members describedand prioritized important components of educational reform for Walnut School. The prioritizedlist included: quality education; continuous improvement; preparation for kids future; sports andfine arts; keeping children in our community; community support; finances; engaged andinspired staff; and a family feel. This charter is being formed to address the unique needs ofthis community's children. It will empower our staff, parents, and community the opportunity tobuild partnerships together in addressing our unique educational and cultural needs.

    Ballot Results

    Ballots were made available to parents and the community at several informational meetings, viathe Walnut Community School District's official newspaper of publication, on the Friends ofWalnut Community School website, at Walnut City Hall, the local USPS office, the local publiclibrary, and from any charter school committee member in either paper or electronic format.

    Parent Results (family units):

    (44) in support of K-12 charter application

    ( 3) against

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    Community Results:

    (107) in support of K-12 charter application

    (2) undecided

    (4) against

    An anonymous staff vote was collected by a local member of the clergy on September 26, 2012and results were counted at a public meeting under his supervision immediately thereafter.

    Certified Teaching Staff Results:

    10 (ten) in support of K-12 charter application

    8 (eight) against

    Non-Certified Staff:

    4 (four) in support of K-12 charter application

    6 (six) against

    Charter School Overview (40 total points)

    "Good character is more to be praised than outstanding talent. Most talents are to some extent agift. Good character, by contrast, is not given to us. We have to build it piece by piecebythought, choice, courage and determination."

    John Luther

    Mission and Vision

    The Walnut Charter School strives to create a service-learning environment where ourstudents can draw upon the knowledge and strength of character of our staff, parents, andcommunity members to help them become well-educated, morally and ethically courageouscitizens of our society.

    Why is the charter school being formed and what is its purpose?

    President and CEO of the Character Education Partnership, Mark Hyatt, says, For much of ourhistory as a nation, schools did focus on both academics and character development. Oneprepared young people to succeed in the workforce, and the other prepared them to be morehonest, ethical, engaged citizens. Over time, however, we drifted away from the character

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    mission of schools to focus exclusively on academics. Chartering our school allows us to focuson and emphasize character-building and service to others, and supports our parents, andespecially our staff, in developing creative ways to draw upon their own love of teaching andinnate strengths to build a quality education system right here in our own community. A 2002national study of Learn and Serve America programs suggests that effective service-learning

    programs improve academic grades, increase attendance in school, and develop personal andsocial responsibility (Melcior & Bailis, Impact of Service-Learning on Civic Attitudes andBehaviors of Middle and High School Youth: Findings from Three National Evaluations, 2002).Whether the goal is academic improvement, personal development, or both, service-learning canhelp students learn critical thinking, communication, teamwork, civic responsibility,mathematical reasoning, problem solving, public speaking, vocational skills, computer skills,scientific method, research skills, and analysis. Service-learning is an effective teaching methodfor all students, including gifted and talented students, special education students, students withdisabilities, at-risk youth, youth in inclusive classrooms, and students in alternative education.(www.servicelearning.org/faq)

    Since Lindbergh High School in St. Louis, Missouri implemented character education in 1999,

    student achievement on Missouris tests improved from 24% to 84% proficient/advanced in mathand from 10% to 66% in communication arts. Data points from all 44 national schools ofcharacter show similar gains: 87% of students reported that they felt safe or that bullying wasrare; 89% of the schools reporting said they experienced declines in disciplinary referrals or hadrates that were extremely low; 100% of the schools reporting experienced an increase in statereading and math scores; and 78% of the schools made Annual Yearly Progress (AYP), wellabove the national average (Mark Hyatt.)

    What is the mission or broad goal of the charter school?

    It is the broad goal of the Walnut Charter School to cultivate a passion for lifelong learning and a

    dedication to ethical leadership and civic responsibility among the children in our community; toraise awareness among them of the values and ethics passed down through the generations in ourrural community and how these values affect them every day; and to preserve the history of ourschool while instilling in our students the 21

    stcentury skills necessary for success.

    What are the anticipated outcomes? How will the charter school monitor progress and achieveresults?

    The Walnut Charter School shall utilize the Iowa/Common Core to establish its core academicindicators and curricular standards. Student achievement data shall be collected in multipleways, including, but not limited to, Iowa Assessments, Dynamic Indicators of Basic EarlyLiteracy Skills (DIBELS), Basic Reading Inventory (BRI), and NWEA. Walnut Charter School

    shall develop and implement standards-based report cards for grades K-5 and standards-basedgrading for grades 7-12. Report cards for grades 7-12 shall reflect both a letter grade and detailsof the standards met by the student.

    Students in the Walnut Charter School shall compile a portfolio of their character education andservice learning, with evidence including, but not limited to, documentation of the

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    implementation and results of their Community Action Projects (CAP), personal reflections oftheir own character growth and service learning, assigned essays relating to each grade levelscharacter focus, and letters of recommendation from persons other than school employees, otherevidence as suggested by their classroom teacher. Within these portfolios, students will provideevidence of learning and growth within each component of the schools chosen traits of

    character, increased understanding of civic responsibility and good citizenship, and identify theclassroom skills and knowledge utilized in the project.

    It is the broad goal of the Walnut Charter School to cultivate a passion for lifelong learning and adedication to ethical leadership and civic responsibility among the children in our community; toraise awareness among them of the values and ethics passed down through the generations in ourrural community and how these values affect them every day; and to preserve the history of ourschool while instilling in our students the 21st century skills necessary for success. These goalswere determined as a means of response to the specific needs of the district and the community.

    Describe the characteristics of the community, including race, ethnicity, socioeconomicbackground, and primary languages spoken.

    The Walnut Community School District is located in a rural area of southwest Iowa. As of thecensus of 2010, there were 1193 people, 521 households, and 343 families in the district. Thepopulation density of the school district is 13.76 inhabitants per square mile. The racial makeupof the city was 97.4% White, .67% African American, 0.84% Asian, 0.34% from other races, and0.67% from 2 or more races. Hispanic or Latino of any race was 1.26% of the population.

    High school graduates in the district make up 86.8% of the population. Only 12.1% have a

    bachelors degree or higher. Both of these figures are below the state average. Approximately

    5.2% of the families in the community, and 8.5% of the total population are below the poverty

    line. Median household income is $36,150, which is below the state and national average. The

    majority of our students qualify for the free or reduced lunch program. The primary languagespoken is English.

    What innovative (new or novel) approaches will be utilized?

    Chartering our school will allow us to utilize new and innovative approaches to educationincluding: our Community Action Project program in which students grow and develop throughservice-learning projects; our recent upgrade to 1:1 technologies that will provide our studentswith the 21

    stcentury skills for success; a signed letter of understanding with staff, students and

    families that clarifies our goals and focus; and a new curriculum that will enhance a characterand service- centered approach to learning that focuses on our students' unique talents and gifts.

    The Walnut Charter School recognizes the importance of and has decided to pursue educationand curriculum which promotes 21

    stCentury learning, and will continue to provide 1:1 mobile

    technology for every student in our school. All students 5th grade and younger have been issuedan iPad. Grades 6-8 have been issued Windows-based HP laptops. All high school students have

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    been issued MacBooks. Technology utilization such as this will be integrated into the curriculumas a routine piece of curriculum and instruction, and not simply utilized as an add-on tool.

    What will be the specialized focus of the charter?

    The focus of our charter is character education and service to others. Character education shall bea daily component of classroom learning and conversations, and shall be taught, modeled, andexercised in every school setting. Comprehensive character education addresses many toughissues in education while developing a positive school climate. Each year our students will berequired to develop a Community Action Project. This program will be teacher-led. However,our students can utilize the knowledge and skills of other school employees, appropriate experts,and approved community volunteers. The students' CAP programs will evolve as they advance tothe upper grade levels. For example, though the Kindergarten Community Action Project may bea class effort, high school seniors will be expected to complete a more independent and involvedservice-learning project.

    Organization and Structure

    The Walnut Charter School shall be supervised by the Walnut Charter School Advisory Councilwhich includes seven (7) unpaid members who must reside within the boundaries of the WalnutCommunity School District. The Advisory Council will serve as the immediate oversightmechanism for the school and make recommendations to the Walnut Community School DistrictBoard of Education in regards to Walnut Charter School's staffing needs, curriculum needs,charter focus, or adjustments thereof, and shall in all decisions and recommendations make theeducational, social, emotional and physical needs of those students enrolled in the Charter

    School its primary consideration. It is understood that meetings of the Advisory Council aresubject to the provisions of the Iowa Code Chapters 21 and 22.

    The School Board will review the progress of the Walnut Charter School as it relates to studentachievement and assess the impact on district achievement goals. As a result of consultation withthe Advisory Council, the School Board shall decide matters related to the operation of theschool, including budgeting, curriculum, and operating procedures, keeping in mind the idealsset forth in the Charter. The school principal and/or superintendent will report monthly to boththe Advisory Council and the School Board.

    Initially, the Advisory Council shall consist of the four original Charter Application Committeemembers, Shannon Griffith (current School Board President,) and two additional persons whoshow a keen interest in the education of the children of the community. Advisory Councilmembers must be at least 18 years of age and must have earned a high school Diploma, G.E.D, orthe equivalent. New members of the Advisory Council shall be nominated by current AdvisoryCouncil members and installed at a regular Advisory Council meeting in a timely manner. The

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    initial term of the Advisory Council will begin January 1, 2013 and continue through the firstfour academic years of the Charter. Each term thereafter will last 3 years, and members shall notserve more than three full consecutive terms. If so appointed, former Advisory board membersmay return to service after at least a three-year sabbatical. In the year 2017 two members willvacate their positions and new members will be installed, following suit in 2020 and subsequent

    terms so that consistency and stability on the board shall be maintained. In keeping with IowaLaw, not more than one School Board member shall serve on the advisory board at one time.After the inaugural term, the member position held by Shannon Griffith shall rotate among boardmembers at three-year intervals.

    Advisory Council members must vow to uphold and promote the ideals set forth in this CharterApplication and to set a positive example for all students and staff, in word and in deed, whileholding this position. Advisory Council members shall maintain the persona of servant-leadership and strive to promote a positive and collaborative relationship with the School Board,school administration, staff members, students, parents/guardians and the public. In accepting anappointment to the Advisory Council, members agree to spend not less than six (6) regular-school-day hours per semester observing and interacting with students and staff at Walnut

    Charter School for the purpose of gathering data and sharing information with the AdvisoryCouncil. Accolades for students and staff is to be encouraged. Any Advisory Council membersthat are also on staff shall be allowed to arrange their schedule in such a way that they are able tomeet the six-hours-per-semester requirement. The Walnut Charter School will provide asubstitute teacher if that is deemed necessary.

    The membership of an advisory council appointed or formed shall not include more than onemember of the local school board. The advisory council shall, to the greatest extent possible,reflect the demographics of the student population to be served by the pubic charter school.

    Walnut Charter School will serve students in Kindergarten through Twelfth Grade and will

    continue to house our highly regarded Pre-School and Pre-Kindergarten programs. Training andenrichment offered to K-12 staff and students will also be offered to the pre-school / pre-Kindergarten staff and students. They will be encouraged to attend and participate as theirschedules allow. These very young pupils are a cherished part of our educational community andare likely to be recipients of older students' CAP efforts. Total initial enrollment for Kindergartenthrough Twelfth grade is estimated at 117.

    All persons five to twenty-one years of age residing within the boundaries of the WalnutCommunity School District who have not earned a high school diploma and whoseparents/guardians agree to the Charter School Letter of Understanding will be granted admissionto the Walnut Charter School. This policy supports the purpose and specialized mission of theWalnut Charter School. Should expected enrollment for an upcoming year exceed 350 students, a

    lottery selection will occur. A drawing will be conducted by the school board president, verifiedby the school board secretary at an official board meeting. The admission process shall notdiscriminate against prospective students on the basis of race, creed, color, sex, sexualorientation , gender identity, national origin, religion, SES, marital status, or disability, except ifa charter school limits enrollment pursuant to Iowa Code section 256F.4(3) which states: Acharter school shall not discriminate in its student admissions policies or practices on the basis of

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    intellectual or athletic ability, measures of achievement or aptitude, or status as a person with adisability: however, a charter school may limit admission to students who are within a particularrange of ages or grade levels or on any other basis that would be legal if initiated by a schooldistrict. Enrollment priority shall be given to the siblings of students enrolled in a charter school.Additionally, the following categories of applicants may be exempted from the lottery and gain

    immediate enrollment on this basis:

    1. Students who are enrolled in Walnut Community School at the time it is converted into apublic charter school;

    2. Students who are eligible to attend, and are living in the attendance area of WalnutCommunity School District;

    3. Siblings of students already admitted to or attending the same charter school;4. Children of the charter school's founders, teachers, and staff (so long as the total number

    of students allowed under this exemption constitutes only a small percentage of theschool's total enrollment.)

    Hiring shall, to the greatest extent possible, reflect the demographics of the student population tobe served by the public charter school. Walnut Charter School staff members are consideredemployees of Walnut Community School District and shall hold appropriate licenses. It is thegoal of this Charter to maintain a highly competitive and respected K-12 school in thecommunity of Walnut. Walnut Community School District Employees will be the new WalnutCharter School staff. All hiring and interview processes will include discussion of applicants'abilities and desire to execute the tenets and ideals set forth in this charter and will pay particularattention to each applicant's willingness to work collaboratively with others to meet the goals of

    the charter and the needs of the students and community they serve. Upon acceptance of thischarter application, the district shall advertise and actively seek replacements for retiringadministrators and additional staff. The charter school will hire additional staff to fulfill needs asspecified in the budget narrative.

    In keeping with the District's desire to see each student succeed in the 21stcentury, a wide varietyof innovative online learning opportunities shall be afforded students on a case-by-case basis.Walnut Charter School will assign staff to handle a variety of vocational-technical programs, aswell as those programs currently offered by Walnut Community School. While the teaching staffwill be the primary leaders of their assigned students' CAP programs, all staff will be expected towork in concert with other school employees, appropriate experts, and approved community

    volunteers to encourage a deeper understanding, and to put into practice, the qualities of serviceand character.

    Upon acceptance of the charter application, the evaluation procedures set forth in current teachercontracts will be re-negotiated to reflect inclusion of the ideals and tenets of the charter. Theevaluation process for guidance counseling program personnel will include ASCA Model

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    Counselor Standards. Administrative personnel will maintain their own portfolios which willinclude an improvement plan designed around their particular strengths and weaknesses,submitted to the superintendent and Advisory Council at the beginning of each school year,reviewed periodically throughout the year by the superintendent and the employee, and evaluatedat least yearly by the same. Each staff member shall sign the staff Letter of Understanding which

    states they will agree and adhere to the values and tenets of the charter. Changes in staff may berecommended by the Advisory Council to the School Board and a cooperative relationshipbetween the two groups shall ensure Walnut Charter School has strong, trustworthy, andintegrity-filled leadership in place at all times.

    It is the position of Walnut Charter School that in order to promote professional developmentwhich is most effective for our staff, certified teachers will have a large amount of influence andinput in the planning of the content and structure of that program. Appropriate cohorts will beformed and maintained as they pertain to instructional sections by grade or content area, and inwhichever ways will be most effective. Staff is encouraged to seek out, share, and personalize theinstructional and organizational tools they feel would have the greatest impact on their owndevelopment as a teacher and which would in turn have the greatest impact on student learning

    and success. In addition, individual teachers are encouraged to observe their colleagues withinthe school or to do so in another district. Teachers who choose to take advantage of this programwill need advance permission from Walnut Charter School administration and a partner district,if necessary. Up to 2 days per semester will be allowed. A brief summary of ideas, strategies, orknowledge gained from these sharing experiences will be reported to the Advisory Council inwriting or in person at the next regular Advisory Council meeting.

    In the unlikely event that the Walnut Charter School fails to demonstrate significant progress inimproving student learning or presents a risk to the health and safety of students and staff, thecharter will be revoked or non-renewed and the school will be dissolved. The Walnut CharterSchool students will be enrolled in the Walnut Community School. Staff will be reassigned to

    positions within the Walnut Community School. All assets (furniture, materials, funds, etc.) willbe absorbed by the district.

    A dress code shall be established for all students, staff, volunteers, and guests, and shall beenforced at every school function. All staff are expected to enforce the dress code for everyWalnut Charter School Student.

    The Pledge of Allegiance shall be part of the daily routine for grades Kindergarten throughtwelve.

    In order that our staff, students, and their families have time to share with one another, no schoolactivities will occur after 6:30 p.m. on Wednesdays. No school activities will occur before 2:00

    p.m. on Sundays (excluding the annual Post Prom Party) and no regularly scheduled activitiesshall occur after 2:00 p.m. on Sundays (excluding Graduation Commencement). The rareexception will be addressed on a case-by-case basis with school administration.

    All teachers shall conduct in-home visits with the families of their students prior to the start ofeach school year. While called in-home visits, these visits will be in a location determined by

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    the parent/guardian. At the elementary level, these visits are class visits, but at the secondarylevel, home visits will be conducted by class sponsors/CAP advisors. At these visits, teacherswill share their goals for students and parents will share theirs. Teachers will share withparents/guardians the Letter of Understanding and discuss any possible areas of expertise orvolunteerism for the parent/guardian. Families will also be provided the opportunity to register

    their children for school during these visits.Waivers Requested by Walnut Charter School

    FEDERAL: Public Law 111-296,Healthy, Hunger-Free Kids Act of 2010, Sec. 208. Nutritionstandards for all foods sold in school.

    STATE OF IOWA Waivers are from Chapter 12 of the Iowa Code:

    281-12.2(256) 12.3(12)a. Library Program. The Library program is planned and implemented bya qualified teacher librarian working collaboratively with the district's administration andinstructional staff.

    12.3(9) Grade Level Organization. The board shall adopt a grade-level organization for thebuildings under its jurisdiction.

    12.4(1) Instructional professional staff. Each person who holds a license/certificate endorsed forthe service for which that person is employed shall be eligible for classification as a member ofthe the instructional professional staff.

    12.4(8) Teacher. A teacher shall be defined as a member of the instructional professional staffwho holds a license/certificate endorsed for the type of position in which employed.

    12.5(3) Elementary program, grades 1-6. The following areas shall be taught in grades onethrough six: English-language arts, social studies, mathematics, science, health, human growth

    and development, physical education, traffic safety, music, and visual art.

    12.5(4) Junior high program, grades 7 and 8. The following shall be taught in grades 7 and 8:English-language arts, social studies, mathematics, science, health, human growth anddevelopment, physical education, music, visual art, family and consumer education, careereducation, and technology education.

    12.5(5) High school program, grades 9-12. In grades 9 through 12, a unit is a course orequivalent related components or partial units taught throughout the academic year as defined insub-rule 12.5(14). The following shall be offered and taught as the minimum program: English-language arts, six units; social studies, five units; mathematics, six units as specified in 12.5(5)

    c; science, five units; health, one unit; physical education, one unit; fine arts, three units;foreign language, four units; and vocational education, 12 units as specified in 12.5.(5) i.

    12.5(14) Unit. A unit is a course which meets one of the following criteria; it is taught for at least200 minutes per week for 36 weeks; it is taught for the equivalent of 120 hours of instruction; orit is an equated requirement as a part of an innovative program filed as prescribed in rule12.9(256).

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    12.15(15) Credit. A student shall receive a credit or a partial credit upon successful completion ofa course which meets one of the criteria in sub-rule 12.5(14).

    12.15(16) Subject offering. A subject shall be regarded as offered when the teacher of the subjecthas met the licensure and endorsement standards of the state board of educational examiners ofthat subject. 12.5(19) Physical activity requirement. Subject to the provisions of sub-rule 12.5(6),physically able pupils in grades 6 through 12 shall engage in physical activity for a minimum of120 minutes per week in which there are at least five days of school.

    12.7(1) Provisions for school district professional development. To meet the professional needsof all staff, professional development activities shall align with district goals.

    12.8(1) Comprehensive school improvement(a)(2). School improvement advisory committee. Tomeet requirements of Iowa Code section 280.12(2) as amended by 2007 Iowa Acts, Senate File61, section 1, the board shall appoint and charge a school improvement advisory committee tomake recommendations to the board.

    12.8(1) Comprehensive School Improvement (f.) Assessment of student progress. Performancelevels. A school or school district shall establish at least three performance levels on at least onedistrict-wide valid and reliable assessment in the areas of reading and mathematics for at leastgrades 4, 8, and 11 and science in grades 8, and 11 or use the achievement levels as established bthe Iowa Testing Program to meet the intent of this subparagraph (2).

    (See Appendix: List of Requested Waivers)

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    Facilities/Financial Support

    The entire Walnut School District buildings and included assets will be available to be utilizedfor the charter, as agreed upon by the Walnut School Board.

    At the time of application the facilities and assets of the Walnut School District to be utilized by

    the Walnut Charter School include:17 Classrooms 3 Libraries

    2 Computer Labs 4 Sets of Restrooms

    1 Laundry Facility 7 Janitorial Closets

    3 Storage Rooms 1 Weight Room

    1 Lunchroom (with storage area) 1 Freezer/refrigerator room

    8 Offices (including Administration offices) 2 Concession Stands

    3 Lobbies 2 Gymnasiums (including fully functional sport facilities)

    2 Sets of locker rooms and showers 1 Garage

    1 Technology Office 1 Wrestling Room

    1 Industrial Arts Classroom 1 Theatrical Stage

    1 Functional ICN classroom 1 Pre-K Classroom (including office & storage)

    1 Band room (including office & storage) 1 Choir room (including office & storage)

    1 Fully stocked science lab 1 Green area/walkway1 Bicycle area 1 Playground

    1 Blacktop/recess area 1 Outdoor Basketball Court

    The District also offers a sufficient number of lockers, textbooks, and desks for each studentalong with 1 to 1 technology for every student grades K through 12. The assets of the musicdepartment include risers and sound shells for performance and instruments and media forstudents' use and accompaniment. The District also has a long-standing, cordial relationship withthe City of Walnut allowing the District to utilize sports facilities including a football/soccerfield, sand volleyball court, baseball field, softball field, and little league ball field as the Districtsees fit.

    Because Walnut Charter School will include the entire K-12 district, the services the district nowprovides will continue to be provided under the charter. This includes a meal program, possibleathletic programs, special education, TAG services, and transportation. The budget for the

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    Learn and Serve America: This year the Corporation for National and Community Service will

    commit more than $17,400,000 to support Iowa communities through national service initiatives.

    This includes education based efforts that focus on service. A number of Iowa schools and

    communities already participate in this program and 13 of the total 18 participants are K-12

    school based.

    Innovative Approaches to Literacy: minimum amount given is $150,000, maximum amount

    given is $750,000, for 24 months

    National Science Foundation STEM Grant: up to $250,000 for 2 years

    Clorox Grant: $50,000 1 time

    NEA Foundation: Student Achievement Grants: Max of $5000

    Other various organizations and institutes that offer large, education-based grants: Lego

    Foundation, Bill and Melinda Gates Foundation, The Kimmel Foundation (specific to Iowa andNebraska), Daniels Fund, Alfred P. Sloan Foundation, and many others.

    Miscellaneous CAP Grants: Vista Program, Promise Partners, Points of Light.org, Generation

    On, Reach Out Iowa, Pottawattamie Youth Council, Do Something.org, Pepsi. (all of varying and

    individual amounts)

    As additional resources are received, a more aggressive approach to implementing programs will

    occur.

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    Student Achievement

    The Walnut Charter School will implement a school-wide character program. This is expected tohave a positive impact on disciplinary referrals, attendance, and bullying incidents. The CAPprogram shall also have a positive impact on these things, as well as on graduation rate,

    community connections and involvement within the educational program, and parentalengagement with the school.

    Students in the Walnut Charter School shall compile a portfolio of their character education andservice learning, with evidence including, but not limited to, documentation of theimplementation and results of their Community Action Projects (CAP), personal reflections oftheir own character growth and service learning, assigned essays relating to each grade levelscharacter focus, and letters of recommendation from persons other than school employees, otherevidence as suggested by their classroom teacher. Within these portfolios, students will provideevidence of learning and growth within each component of the schools chosen traits ofcharacter, increased understanding of civic responsibility and good citizenship, and identify the

    classroom skills and knowledge utilized in the project.In accordance with Iowa Code section 256.7 (21) and 281 Chapter 12, Walnut Charter Schoolshall develop, implement, and file with the Iowa Department of Education a comprehensiveschool improvement plan (CSIP) that includes, but is not limited to, demonstrated school,parental, and community involvement in assessing educational needs, establishing localeducation standards, student achievement levels, and, as applicable, the consolidation of federaland state planning, goal-setting, and reporting requirements.

    The Walnut Charter School shall establish an American School Counselor Association (ASCA)National Model: A Framework for School Counseling Programs. The ASCA Model has its ownAdvisory Board, ideally made up of an administrator, parents, students, community member(s),

    the school counselor, and a school counselor from another district. The Model includes beliefs, aphilosophy, and a mission statement established by the Models Advisory Board, and itsimplementation utilizes data-driven standards and lessons.

    The goal of increased parent/guardian participation and input into the educational program at theWalnut Charter School shall be achieved through this ASCA Model Advisory Board, thecharters Advisory Council, the CAP program, and the parents Letter of Understanding.

    The Walnut Charter School shall utilize the Iowa/Common Core to establish its core academicindicators and curricular standards. Student achievement data shall be collected in multiple ways,including, but not limited to: Iowa Assessments; Dynamic Indicators of Basic Early LiteracySkills (DIBELS); Basic Reading Inventory (BRI); and NWEA. DIBELS assessments shall be

    given each fall, winter, and spring for all elementary students. NWEA assessments will be givenin the fall and spring to K-11 students. Iowa Assessments shall be given to grades 2-11. In yearone. Baseline student achievement data shall be determined in the first year of the charter, withmeasurable achievement gains made each subsequent year. The Walnut Charter School shalldevelop and implement standards-based report cards for grades K-5 and standards-based grading

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    and reporting for grades 6-12 in year two. Report cards for grades 6-12 shall reflect both a lettergrade and details of the standards met by the student.

    Iowa Learning Online and e2020 shall be offered to students to take courses not offered on siteand/or for credit recovery purposes.

    Competency Based Education has been shown to work well for drop-out prevention, creditrecovery, as well as the talented and gifted students. This is an individualized, differentiated, andstudent-centered method of education which increases student engagement and motivation.Students advance upon mastery rather than through accumulated seat time. The Walnut CharterSchool shall transition to this educational method for grades K-5 in year two, and 6-12 in yearthree.

    Science Writing Heuristic (SWH) shall be implemented in grades 4-12. SWH is a way totransform students' scientific thinking into science writing. The SWH approach has been provento close the achievement gap. Through the use of SWH, studies have found increasedperformance on the Iowa Assessments and greater achievement of students with IEPs. The SWH

    approach was designed to create experiences for students to engage in science inquiry and to usescientific language. SWH is designed to promote classroom discussion where students' personalexplanations and observations are tested against the perceptions and contributions of the broadergroup. Learners are encouraged to make explicit and defensible connections between questions,observations, data, claims, and evidence. Students use diverse forms of language to describe apattern, make a generalization, state a relationship, or construct an explanation. The templateprovides a plan for students investigation and a complementary teacher plan for helping studentsnegotiate meaning throughout the SWH investigation.

    In addition to the meetings outlined in and data gathered for the CSIP, the Walnut CharterSchools Advisory Council shall initially meet once per month and receive information fromadministration on the schools progress in meeting its established educational, character, andservice goals. The Advisory Council shall provide recommendations to the administration andWalnut Community Schools Board of Education regarding identified concerns and areas forimprovement.

    It is the mission and broad goal of the Walnut Charter School to cultivate a passion for lifelonglearning and a dedication to ethical leadership and civic responsibility among the children in ourcommunity; to raise awareness among them of the values and ethics passed down through thegenerations in our rural community and how these values affect them every day; and to preservethe history of our school while instilling in our students the 21st century skills necessary forsuccess. These goals were determined as a means of response to the specific needs of the districtand the community.

    The founding members of the Walnut Charter School have extensive familiarity with parent andfamily needs in the Walnut community, and will respond to these needs by offering family andcommunity support in a variety of ways. One such method is that of the Community ActionProjects to be completed by the students and their supervising staff. These projects are meant toinstill character in our students and to integrate service projects with classroom learning.

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    www.learnandserve.gov states Service-learning engages students in the educational process,using what they learn in the classroom to solve real-life problems. Students not only learn aboutdemocracy and citizenship, they become actively contributing citizens and community membersthrough the service they perform. Service-learning can be applied across all subjects and gradelevels; it can involve a single student or group of students, a classroom or an entire school.

    Students build character and become active participants as they work with others in their schooland community to create service projects in areas such as education, public safety, and theenvironment. Service-learning engages students in the educational process, using what they learnin the classroom to solve real-life problems. Students not only learn about democracy andcitizenship, they become actively contributing citizens and community members through theservice they perform. Service-learning can be applied across all subjects and grade levels; it caninvolve a single student or group of students, a classroom or an entire school. Students buildcharacter and become active participants as they work with others in their school and communityto create service projects in areas such as education, public safety, and the environment.Character education shall be a daily component of classroom learning and conversations, andshall be taught, modeled, and exercised in every school setting. Comprehensive character

    education addresses many tough issues in education while developing a positive school climate.Research shows that educators have transformed their school cultures, reduced disciplinereferrals, increased academic achievement for all learners, developed global citizens, andimproved job satisfaction and retention among teachers through implementation of acomprehensive character education program.

    Character education and service learning go hand-in-hand in accomplishing the tenants andvision of the Walnut Charter School. Character education is the intentional effort to develop inyoung people core ethical and performance values that are widely affirmed across all cultures. Tobe effective, character education must include all stakeholders in a school community and mustpermeate school climate and curriculum. Character education includes a broad range of conceptssuch as positive school culture, moral education, just communities, caring school communities,

    social-emotional learning, positive youth development, civic education, and service learning. Allof these approaches promote the intellectual, social, emotional, and ethical development ofyoung people and share a commitment to help young people become responsible, caring, andcontributing citizens. Character education so conceived helps students to develop importanthuman qualities such as justice, diligence, compassion, respect, and courage, and to understandwhy it is important to live by them. Quality character education creates an integrated culture ofcharacter that supports and challenges students and adults to strive for excellence. When studentsfeel respected, cared for, and safe, they are better prepared and willing to learn. Charactereducation influences many things, including student achievement, disciplinary referrals, schoolattendance, drop-out, and graduation rates.

    The choice of service-learning and character focus for Walnut Charter School shall accomplishthe following: improved student learning, as evidenced on Iowa Assessments and districtassessments; increased learning opportunities for students, as evidenced by the creation of theCAP program and increased community and parental expertise in and out of the classroom;encouraged use of different and innovative methods of teaching; requirement of a studentportfolio which outlines student character and service-learning; creation of new professional

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    learning opportunities for educators, including the opportunity to be responsible for the learningprogram at the school site through the leadership of students in Community Action Projects andworking in concert with other staff at distinctly different grade levels to foster collaborativelearning with the students; and allowance for greater flexibility to meet the educational needs ofthe student population.

    Innovative teaching methods to be utilized include: Community Action Projects where thestudents can learn through service learning projects; 1:1 technology, which will assist inproviding our students with the 21st century skills necessary for success; a signed letter ofunderstanding with staff, students, and families that clarifies the schools goals and focus;utilization of the ASCA National Model; collaborative instruction; problem/project-basedlearning; establishing community partnerships via experiences such as field trips, assemblies,mentorships, and classroom presentations; and an expanded curriculum that will enhance acharacter and service-centered approach to learning which focuses on our students uniquetalents and gifts.

    Family support and family involvement are at the core of raising solid students. A key

    component of our character and service-learning focus is nurturing the relationship betweenstudent success and family involvement. Walnut Charter School recognizes the unique assets ofeach student and family and is excited to draw upon the special gifts and talents each person hasto offer. Active family engagement in the school will model appropriate service-learningbehaviors for our students and will result in strong partnerships among the staff, students,families, and the community of Walnut. Each family shall offer a gift of time equivalent to, orexceeding, 8 hours per academic year.

    Walnut Charter School shall develop an in-coming student induction program which familiarizesnew students to the school with the character focus and expectations of their academic andbehavioral performance. This induction program shall also include assessments of the new

    students knowledge and academic achievement thus far in comparison with that of theclass/grade which they are entering. The induction program shall provide additional academicsupport for new students, if necessary.

    The Walnut Charter School shall meet all applicable federal, state, and local health and safetyrequirements and laws prohibiting discrimination on the basis of race, creed, color, sex, sexualorientation, gender identity, national origin, religion, SES, marital status, or disability. WalnutCharter School shall be subject to any court-ordered desegregation plan in effect for the schooldistrict at the time the charter school is approved. Walnut Charter School shall operate as a non-sectarian, non-religious public school. It shall be free of tuition and application fees to Iowaresident students between the ages of 5 and 21 years. The school be subject to and comply withChapters 216 and 261A relating to civil and human rights. It shall provide special education

    services in accordance with Chapter 256B. Walnut Charter School shall be subject to the samefinancial audits, audit procedures, and audit requirements as a school district. The audit shall beconsistent with the requirements of Sections 11.6, 11.14, 11.19, 256.9, subsection 20, and section279.29, except to the extent deviations are necessary because of the program at the school. Thedepartment, the auditor of state or the legislative services agency may conduct financial,program, or compliance audits. The school shall be subject to and comply with Chapter 284

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    relating to the student achievement and teacher quality program. A charter school that complieswith Chapter 284 shall receive state moneys or be eligible to receive state moneys calculated asprovided in section 257.10, subsections 9 and 10, and section 257.37A as if it did not operateunder a charter school contract. Walnut Charter School shall be subject to and comply withChapter 20 and 279 relating to contracts with and discharge of teachers and administrators. It

    shall be subject to and comply with the provisions of Chapter 285 relating to the transportation ofstudents. Meetings and records of the Advisory Council are subject to the provisions of Chapters21 and 22.

    The Walnut Charter School will make quarterly reports to the Walnut Community School Board,the Walnut Charter School Advisory Council, and parents/families. Quarterly reports will beavailable to the public on the school website or in print form if requested.

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    Appendix

    Waivers Requested by the Walnut Charter School

    FEDERAL:

    Public Law 111-296,Healthy, Hunger-Free Kids Act of 2010, Sec. 208. Nutrition standards forall foods sold in school. NEW Lunch Meal Pattern:

    RATIONALE: This Act assumes that all children of any given age will have identical andinterchangeable dietary protein and calorie requirements. It also assumes that proteins areidentical and interchangeable. It fails to account for any variance for students activity levels or

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    height. It also assumes that all children will receive enough food when they are not at school.This, we know, is not the case for all families within the Walnut School District. Walnut is also arural farming community, and therefore the activity level of our children is much greater thanthat of an urban or suburban child.

    STATE OF IOWA Waivers are from Chapter 12 of the Iowa Code:281-12.2(256) 12.3(12)a. Library Program. The Library program is planned and implemented bya qualified teacher librarian working collaboratively with the district's administration andinstructional staff.

    RATIONALE: Access to print and electronic resources will be an integral part of the studentsdaily learning experiences. A partnership with the Walnut Public Library will be established.

    12.3(9) Grade Level Organization. The board shall adopt a grade-level organization for thebuildings under its jurisdiction.

    RATIONALE: This school may be organized in grade bands, with students in multi-ageclasses. Advancement will depend on demonstrating the competencies as outlined in the Iowa

    Core Curriculum, not through the accumulation of seat time. Students programs of study will beindividualized based on interests and career goals, not necessarily on age-alike grouping.

    12.4(1) Instructional professional staff. Each person who holds a license/certificate endorsed forthe service for which that person is employed shall be eligible for classification as a member ofthe the instructional professional staff.

    RATIONALE: Instructional staff will be hired and placed based on relevant professionalexperience and/or license/certifications held. Secondary staff may be utilized at the elementarylevel, either as specials staff or in collaboration with the elementary classroom teacher.

    12.4(8) Teacher. A teacher shall be defined as a member of the instructional professional staffwho holds a license/certificate endorsed for the type of position in which employed.

    RATIONALE: Instructional staff will be hired and placed based on relevant professionalexperience and/or license/certifications held.

    12.5(3) Elementary program, grades 1-6. The following areas shall be taught in grades onethrough six: English-language arts, social studies, mathematics, science, health, human growthand development, physical education, traffic safety, music, and visual art.

    RATIONALE: The curriculum of this school will follow the Iowa Core Curriculum. Whereverpossible, cross-disciplinary study of authentic and relevant issues and problems will beemployed. Students will advance through coursework by demonstrating mastery and

    performance of core competencies as outlined in the Iowa Core Curriculum, aligned to corecurricular areas and 21st century skills. For these reasons, students may progress through gradebands at differing rates, rather than by the accumulation of seat time.

    12.5(4) Junior high program, grades 7 and 8. The following shall be taught in grades 7 and 8:English-language arts, social studies, mathematics, science, health, human growth and

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    development, physical education, music, visual art, family and consumer education, careereducation, and technology education.

    RATIONALE: The curriculum of this school will follow the Iowa Core Curriculum. Whereverpossible, cross-disciplinary study of authentic and relevant issues and problems will beemployed. Students will advance through coursework by demonstrating mastery and

    performance of core competencies as outlined in the Iowa Core Curriculum, aligned to corecurricular areas and 21st century skills. For these reasons, subject-specific courses in these areasmay not be available in all cases.

    12.5(5) High school program, grades 9-12. In grades 9 through 12, a unit is a course orequivalent related components or partial units taught throughout the academic year as defined insub-rule 12.5(14). The following shall be offered and taught as the minimum program: English-language arts, six units; social studies, five units; mathematics, six units as specified in 12.5(5)c; science, five units; health, one unit; physical education, one unit; fine arts, three units;foreign language, four units; and vocational education, 12 units as specified in 12.5.(5) i.

    RATIONALE: The curriculum of this school will follow the Iowa Core Curriculum. Wherever

    possible, cross-disciplinary study of authentic and relevant issues and problems will beemployed. Students will advance through coursework by demonstrating mastery andperformance of core competencies as outlined in the Iowa Core Curriculum, aligned to corecurricular areas and 21st century skills. For these reasons, subject-specific courses in these areasmay not be available in all cases.

    12.5(14) Unit. A unit is a course which meets one of the following criteria; it is taught for at least200 minutes per week for 36 weeks; it is taught for the equivalent of 120 hours of instruction; orit is an equated requirement as a part of an innovative program filed as prescribed in rule12.9(256).

    RATIONALE: The curriculum of this school will follow the Iowa Core Curriculum. Wherever

    possible, cross-disciplinary study of authentic and relevant issues and problems will beemployed. Students will advance through coursework by demonstrating mastery andperformance of core competencies as outlined in the Iowa Core Curriculum, aligned to corecurricular areas and 21

    stcentury skills. Students will be held to the same standard of

    performance regardless of the time it takes for them to achieve mastery. For that reason, there isno minimum number of minutes or hours required before performance can be demonstrated.

    12.15(15) Credit. A student shall receive a credit or a partial credit upon successful completion ofa course which meets one of the criteria in sub-rule 12.5(14).

    RATIONALE: The curriculum of this school will follow the Iowa Core Curriculum. Whereverpossible, cross-disciplinary study of authentic and relevant issues and problems will beemployed. Students will advance through coursework by demonstrating mastery andperformance of core competencies as outlined in the Iowa Core Curriculum, aligned to corecurricular areas and 21

    stcentury skills. Students will be held to the same standard of

    performance regardless of the time it takes for them to achieve mastery. For that reason, there isno minimum number of minutes or hours required before performance can be demonstrated.

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    12.15(16) Subject offering. A subject shall be regarded as offered when the teacher of the subjecthas met the licensure and endorsement standards of the state board of educational examiners ofthat subject.

    RATIONALE: Instructional staff will be hired and placed based on relevant professional

    experience and/or license/certifications held.

    12.5(19) Physical activity requirement. Subject to the provisions of sub-rule 12.5(6), physicallyable pupils in grades 6 through 12 shall engage in physical activity for a minimum of 120minutes per week in which there are at least five days of school.

    RATIONALE: Health and wellness are critical components of the curriculum in the Iowa CoreCurriculum and, therefore, of this school. Instructional staff will employ various strategiesthroughout the instructional day for physical activity designed to promote life-long wellness.

    12.7(1) Provisions for school district professional development: To meet the professional needsof all staff, professional development activities shall align with district goals.

    RATIONALE: Professional development for staff will focus first on school goals and, ifapplicable, district goals.

    12.8(1) Comprehensive school improvement(a)(2): School improvement advisory committee. Tomeet requirements of Iowa Code section 280.12(2) as amended by 2007 Iowa Acts, Senate File61, section 1, the board shall appoint and charge a school improvement advisory committee tomake recommendations to the board. (See Appendix: List of Requested State Waivers)

    RATIONALE: The Charter School Advisory Council, composed of parents, communitymembers, and a Walnut Community School District Board of Education member, will replace thecomprehensive school improvement committee.

    12.8(1) Comprehensive School Improvement (f.) Assessment of student progress. Performancelevels. A school or school district shall establish at least three performance levels on at least onedistrict-wide valid and reliable assessment in the areas of reading and mathematics for at leastgrades 4, 8, and 11 and science in grades 8, and 11 or use the achievement levels as established bthe Iowa Testing Program to meet the intent of this subparagraph (2).

    RATIONALE: Student performance will be frequently monitored and reported. However,performance levels will be based on competencies as outlined in the Iowa Core Curriculum andnot in age-defined grade levels.

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    Iowa Public Charter School Program Assurances

    Pursuant to Iowa Public Chart School Law, chapter 1124, a developed application for a grantunder the Public Charter School Program (PCSP) must meet all applicable federal, state, andlocal health and safety requirements and laws prohibiting discrimination on the basis of race,creed, color, sex, national origin, religion, ancestry, or disability. A charter school shall be subjectto any desegregation plan in effect for the school district at the time the schools charterapplication is approved the charter school shall:

    A. Implement (i) the objectives of the charter school; and (il) the methods by which the charterschool will determine its progress toward achieving those objectives.

    B. Establish a working relationship between the charter school, the local school board and theschool district.

    C. Involve parents and other members of the community in the planning, program design andimplementation of the charter school.

    D. Request and justify waivers/revisions of any Federal statutory or regulatory provisions thatthe eligible applicant believes are necessary for the successful operation of the charter school,and a description of any State or local rules, generally applicable to public schools, that theapplicant proposes to be waived, or otherwise not apply to, the school.

    E. Participate for the life of the charter in all data reporting and evaluation activities asrequested by the U.S. Department of Education and the Iowa Department of Education; thisincludes participating in any federal or state funded charter school evaluation or studies, finalgrant report documentation and financial statements.

    F. Inform students and parents in the community about the charter school; and an equalopportunity to attend the charter school.

    G. Operate as a non-sectarian, non-religious public school.H. Be free of tuition and application fees to Iowa resident students between the ages of five and

    twenty-one years.

    I. Will comply with all provisions of the Nonregulatory Guidance Public Charter SchoolsProgram of the U.S. Department of Education, which includes the use of a lottery forenrollment if the charter school is oversubscribed.

    J. Be subject to and comply with Chapters 2w16 and 216A relating to civil and human rights.K. Comply with general laws including, but not limited to, the Age Discrimination act of 1975,

    Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972,section 504 of Rehabilitation Act of 1973, and Part B of the Individuals with DisabilitiesEducation Act.

    L. Provide special education services in accordance with Chapter 256B.

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    M.Ensure that a students records, and, if applicable, a students individualized educationprogram as defined in section 602 (11) of the Individuals with Disabilities Act, aretransferred to a charter school upon the transfer of the student from a charter school toanother public school, in accordance with the applicable law (P.L. 107-110, section 5208).

    N. Will comply with all provisions of the No Child Left Behind Act, including but not limitedto, provisions on school prayer, the Boy Scouts of America Equal Access Act, the ArmedForces Recruiter Access to Students and Student Recruiting Information, the Unsafe SchoolChoice Option, the Family educational Rights and Privacy Act (FERPA) and assessments(P.L. 107-110).

    O. Be subject to the same financial audits, audit procedures, and audit requirements as a schooldistrict. The audit shall be consistent with the requirements of sections 11.6, 11.14, 11.19,256.9 subsection 19 and section 279.29 except to the extent deviations are necessary becauseof the program at the school. The department, the auditor of state, or the legislative fiscalbureau may conduct financial, program, or compliance audits.

    P. Will maintain accounting records and other evidence pertaining to costs incurred with theprovision that the records shall be kept available by the grantee during the grant period andthereafter for three full years from the date of final payment. Iowa Department of Educationmust be permitted to audit, review, and inspect the grantees activities, books, documents,papers and other records relating to the expenditures of grant proceeds. The developer furtheragrees to comply with all federal and state audit requirements and ensures that arrangementshave been made to finance those mandatory audits.

    Q. Submit a revised budget narrative and budget narrative and budget to Laurie Phelan at IowaDepartment of Education within 90 days of notification of a grant award; budget changesmust meet the approval of Iowa Department of Education.

    R. Understand that if any findings of misuse of grant funds are discovered project funds must bereturned to the Iowa Department of Education and that Iowa Department of Education mayterminate a grant award upon 30 days of notice if it deems that the developer is not fulfillingthe funded program as specified in the approved grant application.

    S. Be required to maintain all equipment purchased with grant funds in accordance with federallaw and regulations.

    T. Be subject to and comply with Chapter 284 relating to the student achievement and teacherquality program. A charter school that complies with Chapter 284 shall receive state moneysor be eligible to receive state moneys as provided in Chapter 284 as if it did not operate undera charter.

    U. The charter school assures that it will not conduct a program of instruction until such time as:1. The requisite health and safety and accessibility standards for the school building have

    been met according the local fire and health department inspectors;

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    2. Adequate equipment, materials, and guidance and counseling services are available; and,3. Conditions are adequate to provide for the economical operation of the school with an

    adequate learning environment.

    V. The charter school will maintain an active parent/guardian involvement process.W.Be subject to and comply with Chapters 20 and 279 relating to contracts with and discharge

    of teachers and administrators.

    X. Be subject to and comply with the provisions of Chapter 285 and 282.18 subsection 10relating to the transportation of students. (Note: A sending district shall make payments to thecharter school in the manner required under section 282.18, subsection 7)

    Y. Meetings of the advisory council are subject to the provision of Chapters 21 and 22.NOTE: A charter school shall not discriminate in its student admission policies or practices onthe basis of intellectual or athletic ability, measures of achievement or aptitude, or status as a

    person with a disability. However, a charter school may limit admission to students who arewithin a particular range of age or grade level or on any other basis that would be legal ifinitiated by a school district. Enrolment priority shall be given to the siblings enrolled in acharter school.

    The No Child Left Behind Act, Title V, Part B [20 USC 7221c. Section 5204, (e)(4) (B)] states,A local educational agency may not deduct funds for administrative fees or expenses from a subgrant awarded to an eligible applicant, unless the applicant enters voluntarily into a mutualagreed upon arrangement for administrative services with the relevant local educational agency.Absent such approval the local educational agency shall distribute all sub grant funds to theeligible applicant without delay.

    WE, THE UNDERSIGNED, do hereby submit an Iowa Public Charter School Programapplication and agree to the conditions and assurances contained therein.

    Signature:_______________________________ Date:

    School District Superintendant

    Signature:_______________________________ Date:

    School District Board of Education, President

    Signature:_______________________________ Date:

    School District Authorized Representative

    Signature:_______________________________ Date:

    Charter School, Developer/Contact Person

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    Iowa Public Charter School Program

    Application for Public Charter School Planning and Public Charter School Status

    Agreement to Comply with Applicable Law

    Pursuant to Iowa Law, I/we hereby certify and agree that Walnut Charter School, a public schoolseeking authorization pursuant to Iowa Law, will comply with all provisions required for publiccharter schools receiving federal funding through the No Child Left Behind Act, Title V, Part B,Public charter Schools Program and with all other state laws applicable to public bodies and withfederal law applicable to public bodies and with federal law applicable to public bodies or schooldistricts.

    Applicant__________________________________________________________

    If more than one applicant, please have additional applicant(s) sign below:

    Applicant__________________________________________________________

    Applicant__________________________________________________________

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    Appendix: Health Inspection

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    Appendix: Liability Insurance

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    Appendix: Letters of Support

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    Appendix: FY 2013 Walnut School District Budget

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    Appendix: Parent Involvement

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    Appendix: Staff Letter of Understanding

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    Appendix: State Fire Safety Report

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